Psoas Syndrome - Hitler

Question 1

Iliacus origin?

Insertion?

Answer 1

Superior 2/3 iliac crest, ASIS

Lesser trochanter

Question 2

What drugs can treat psoas?

Answer 2

NSAID (MICN) 
Muscle relaxant (MCBC)

Question 4

What do you not want to use when treating psoas syndrome?

Answer 4

Direct stretching or direct ME in acute setting

Heat

Question 6

What are the major PE findings in psoas syndrome?

Answer 6

Tight iliopsoas
Loss of cervical/lumbar lordosis
Abdomen protuberant
Tight hamstrings

Question 7

Where is the dysfunction in the piriformis stage of dysfunction?

Exam? Ex. Right side psoas

Answer 7

Opposite side from psoas

Left foot ER

Question 9

Main fx of psoas?

Answer 9

Hip flexion

ER

Question 10

How shouldn’t you sleep with psoas?

Avoid what else?

Answer 10

On stomach

Bend forward, lean backward when standing

Question 12

What are the 5 stage progression steps of psoas syndrome?

Answer 12

BUSPS

B/l spasm
U/l spasm
Sacral torsion
Piriformis spasm
Sciatic n. irritation

Question 13

What dysfunction for sciatica stage of psoas syndrome?

Exam?

Tx?

Answer 13

Left n. Irritation

Left leg paresthesia, NO neural deficit, + straight leg raise

Add low dose steroid

Question 14

Exam findings w/right psoas on sacral stage?

Answer 14

R sacral sulci deep
L ILA post
+ spring test

Question 15

How often should you passive stretch w/rolled towel?

Active stretch

Supine leg lifts?

Answer 15

TID

5-20x per day

6 inches

Question 18

What treatment should you do in the u/l phase?

Answer 18

1st L1
2nd L2-L5
Psoas stretch
Muscle relaxant + NSAID

Question 19

Psoas minor origin?

Insertion?

Answer 19

T12-L1 Vertebral bodies

Iliac fascia

Question 22

What are common etiologies of psoas syndrome?

Laundry

Answer 22

prolonged sitting/bending
Sit ups
Deadlifts/squats
Quick elongation of psoas
Arthritis of hip
V-S reflexes

Question 23

What is the dysfunction for sacral torsion found in a tight left psoas?

Answer 23

R on L torsion - Axis on side of dysfunction

Right pelvic side shift - away from side of dysfunction

Question 25

Give the order of OMT for treating psoas

Answer 25

L1 and L2 first
Psoas
Piriformis
Sacrum
Inominate
Hip

You down with LPP?
SIH wit it

Question 26

What exams you see in the u/l phase for Right psoas?

Answer 26

R psoas spasm
R short leg
R hip ER

Question 27

Origin of psoas major?

Insertion?

Answer 27

Vertebral bodies of T12-L4 and TPs of L1-L5

Lesser trochanter

Question 29

Pt w/difficulty lying prone, sitting or standing upright, and pain most likely has what?

Answer 29

Psoas syndrome

Question 30

What is the dysfunction in the b/l spasm stage?

Tx?

Answer 30

Lumbar spine flexed

Counterstrain, passive stretch, indirect ME, NSAIDS

Question 32

What orthopedic test is best used for psoas syndrome?

Answer 32

Thomas test

Question 35

Tender points for psoas syndrome?

Answer 35

Iliacus
Low ilium
AL 1-5

Question 36

What is the key dysfunction for a tight psoas found on the left?

Answer 36

L1 F RlSl

Question 38

Piriformis origin?

Insertion?

Answer 38

Sacrum

Greater trochanter

Question 42

Psoas “connects” what part of the spine?

Answer 42

T12-L2

Question 45

What V-S reflexes cause psoas syndrome?

Answer 45

Utereral calculi

Appendicitis